Complex Multiligament Knee Injuries

Multiligament knee injuries are also known as knee dislocations and occur when the end of the femur [thigh bone] separates from the tibia [shin bone], causing multiple knee ligaments to tear. These injuries are very severe and lead to gross instability of the knee. Surgery is usually required to reconstruct the ligaments. This surgery is often extensive and technically demanding.

How it happens

Multiligament knee trauma is frequently the result of a high energy injury such as a car accident or fall from a height. It can also occur from a sports injury, or rarely, a fall at work or during everyday activity. In these injuries, two or more of the major ligaments in the knee are severely injured and require surgery. If three or all four of the major ligaments are injured, the knee may be dislocated.

How it feels

These injuries are usually associated with severe pain and swelling of the knee. Patients can generally not walk and in some cases have damage to the nerves or arteries of the leg. Because many ligaments in the knee are injured, the knee is normally unstable after a period of healing. The patient will feel unstable on their knee and it can feel loose and wobbly.

How it is fixed

In some cases, one or more of the ligaments may heal without surgery. In most patients, surgery is required to reconstruct ligaments. Repair may be performed where the ligaments are stitched back together, but frequently the ligaments must be constructed using a graft to make a new ligament. The graft may be taken from the patient, or frequently donor tissue (allograft) is used since many grafts are required for the procedure.

Recovery/Post-Surgery

After multiligament knee reconstruction, patients are in a brace and do not bear weight on the knee for approximately four weeks, depending on the procedure. Physical therapy is required and crutches are generally used for over one month.